Organization
DIABLO PULMONARY MEDICAL GROUP, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HIROMI C TAKEKUMA D.O. (PRESIDENT)
(925) 676-2942
Entity
Organization
Contact information
Practice address
2299 BACON ST, SUITE 2, CONCORD, CA 94520-2045
(925) 676-2942
(925) 676-7108
Mailing address
2299 BACON ST, SUITE 2, CONCORD, CA 94520-2045
(925) 676-2942
(925) 676-7108
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CJ5117
RAILROAD MEDICARE
CA
05
—
GR0064710
—
CA
Enumeration date
08/11/2006
Last updated
11/01/2013
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